Is there any evidence for milder courses of monkeypox virus infections with childhood smallpox vaccination?

Hoffmann, Christian; Wolf, Eva; Jessen, Heiko; Bickel, Markus; Boesecke, Christoph

doi:10.1007/s15010-022-01923-7

Cited by 7 publications

(3 citation statements)

References 4 publications

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“…This adds to a thus far limited body of evidence concerning vaccine efficiency against severe mpox disease. In a study by Hoffmann et al, a statistically significant association could be demonstrated between childhood smallpox vaccination and higher odds of limited cutaneous mpox disease (defined by lesion count ≤ 3) without systemic symptoms [ 33 ]. Vaccine efficiency for infection prevention cannot be assessed on the basis of the data gathered since only PCR-positive individuals were included in this study, but it is estimated to be between 80 and 85% depending on the type of smallpox vaccine [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Mpox outbreak 2022: an overview of all cases reported to the Cologne Health Department

Kröger¹,

Lehmann²,

Treutlein³

et al. 2023

Infection

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PurposeThe worldwide mpox outbreak starting in May 2022 marks the occurrence of another previously atypical infectious disease in Europe. This study's objective was to present a comprehensive overview based on the gathered data and to illustrate the approach of the Cologne Health Department to contain the mpox outbreak. Methods In this retrospective observational study, 368 individuals reported to the Cologne Health Department as PCRpositive for mpox were included. Data were collected in structured telephone interviews and digitally processed. ResultsThe first mpox case in Cologne was recorded on May 24, 2022. The local outbreak lasted approximately 4 months and reached its peak in July. The last reported case in Cologne occurred on September 17. Transmissions mostly occurred through sexual contacts (67.4%) or other close physical contacts (4.6%) between men, but also through fomites, in the context of events or occasionally in the work environment. In 21.5% of cases, no route of infection could be determined. The mean incubation period was 8.2 days. Clinically, mpox infections usually presented with skin and/or mucosal lesions accompanied by general symptoms. In 74.8% of cases, a prodromal stage was absent. Initially, the rash often had an unspecific appearance, but in the further clinical course, it usually passed through the typical stages. Most infections resolved spontaneously under home care. In 3.5% of cases, however, inpatient hospitalisation was required. Infected persons with a previous smallpox vaccination had 0.43 times the odds of unvaccinated persons to be affected by lesions in 3 or more body regions and 0.30 times the odds to develop lesions in all 5 body regions. Previous vaccination statistically reduced the total duration of symptoms by 2.0 days. Conclusions The mpox outbreak 2022 in Cologne primarily affected men who have sex with men and have reported recent sexual encounters. The observed average incubation period was shorter than initially assumed. Mucosal involvement and associated symptoms occur in a relevant number of cases and can lead to more severe clinical courses. Previous smallpox vaccination was statistically significantly associated with milder courses of mpox. In the case of an unclear rash or symptoms suggesting mucosal involvement, mpox should be considered as a differential diagnosis. An equally rapid and wellorchestrated public health response are crucial for infection control.

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Section: Discussionmentioning

confidence: 99%

Mpox outbreak 2022: an overview of all cases reported to the Cologne Health Department

Kröger¹,

Lehmann²,

Treutlein³

et al. 2023

Infection

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“…It is unclear to what extent prior smallpox vaccination has mitigated the impact of mpox, as information about the childhood vaccination status of our participants was inconsistent and unreliable. A possible protective effect of smallpox vaccination against long-term mpox symptoms has not been described but a possible association of a milder course of mpox disease and history of a previous smallpox vaccination has been discussed by some authors [15,16].…”

Section: Discussionmentioning

confidence: 99%

Persistent morbidity in Clade IIb mpox patients: interim results of a long-term follow-up study, Belgium, June to November 2022

Berens-Riha,

Bracke,

Rutgers

et al. 2023

Eurosurveillance

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While mpox was well characterised during the 2022 global Clade IIb outbreak, little is known about persistent morbidity. We present interim results of a prospective cohort study of 95 mpox patients assessed 3–20 weeks post-symptom onset. Two-thirds of participants had residual morbidity, including 25 with persistent anorectal and 18 with genital symptoms. Loss of physical fitness, new-onset/worsened fatigue and mental health problems were reported in 36, 19 and 11 patients, respectively. These findings require attention by healthcare providers.

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“…This suggests that a single dose of the MVA-BN vaccine offers some protection against mpox infection. In a study to determine whether childhood smallpox vaccination altered the clinical presentation of the MPXV infection, 298 mpox-infected patients were followed up for at least 7 days [ 24 ]. As a result, acute systemic symptoms such as fever and somatic pain were less frequent in the vaccinated group, whereas local skin disease without systemic symptoms (defined as 0–3 lesions) was more frequent in the vaccinated group, with an odds ratio of 4.17 in the vaccinated group (95% CI: 1.63–10.65, p = 0.003).…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Immunogenicity and Safety of a Smallpox Vaccine to Monkeypox in Healthy Japanese Adults: A Single-Arm Study

Tomita

Morino

Terada-Hirashima

et al. 2023

Life

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Monkeypox (mpox) is an acute exanthematous disease caused by the monkeypox virus (MPXV). Since May 2022, patients with mpox have been reported worldwide, mainly in Europe and the Americas. In Japan, LC16”KMB,” which is a smallpox vaccine derived from a dried cell culture, against mpox, has been approved. Although inoculation with a smallpox vaccine has been recommended to prevent MPXV infection, the immunogenicity of the smallpox vaccine against the MPXV is unclear, and information regarding postvaccination safety is scarce. We present the protocol for a single-arm open-label study to investigate the immunogenicity and safety of LC16”KMB” against the MPXV in healthy Japanese adults. The primary endpoint is the seroconversion rate of neutralizing antibodies against the MPXV on postvaccination day 28. The secondary endpoints are the seroconversion rates against the MPXV on postvaccination days 14 and 168; the seroconversion rates against the vaccinia virus on postvaccination days 14, 28, and 168; the incidence of mpox until day 168; and adverse and serious adverse events until postvaccination days 28 and 168. These results will pave the way for larger comparative studies using other smallpox vaccines to evaluate the test vaccine’s safety and efficacy in preventing mpox.

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Is there any evidence for milder courses of monkeypox virus infections with childhood smallpox vaccination?

Cited by 7 publications

References 4 publications

Mpox outbreak 2022: an overview of all cases reported to the Cologne Health Department

Mpox outbreak 2022: an overview of all cases reported to the Cologne Health Department

Persistent morbidity in Clade IIb mpox patients: interim results of a long-term follow-up study, Belgium, June to November 2022

Evaluating the Immunogenicity and Safety of a Smallpox Vaccine to Monkeypox in Healthy Japanese Adults: A Single-Arm Study

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